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General NPI Number Information
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NPI Number | 1033635214
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Entity Type | Organization
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Legal Business Name | NOPLIS PSYCHIATRY LLC
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 8521 LA GRANGE RD
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City | LOUISVILLE
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State | KY
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Zip | 40242-3800
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Country | US
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Telephone | 502-426-6380
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 45
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City | LA GRANGE
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State | KY
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Zip | 40031-0045
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Country | US
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Telephone | 502-265-0491
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Fax | 502-805-0690
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Authorized Official
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Title or Position | MEMBER
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Name | DR. CHARLES NOPLIS II
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Credential | MD
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Telephone | 502-265-0491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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